Order of the Secretary of the Pennsylvania Department of Health for Mitigation Relating to Travel The 2019 novel coronavirus (COVID-19) is a contagious disease that is spreading rapidly from person to person in the world, the United States, and this Commonwealth. COVID- 19 can be transmitted from any person who is infected, even if they have no symptoms. Additionally, exposure is possible by touching a surface or object that has the virus on it and then touching one’s mouth, nose, or eyes. Symptoms of COVID-19 may include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea. Older adults and people who have serious chronic medical conditions are at a higher risk for serious illness. Illness in children and young adults has become more common as the face of the pandemic continues to change. After a brief respite in the summer months, case counts and the number of hospitalizations have been rising throughout the Commonwealth, surrounding states, and the world. There have been 275,513 cases and 9,355 deaths in this Commonwealth caused by the still present and ongoing pandemic. Earlier in the pandemic, I issued an order directing life-sustaining businesses to institute mitigation measures to protect the safety of employees and customers. Order of the Secretary of the Pennsylvania Department of Health Directing Public Health Safety Measures for Businesses Permitted to Maintain In-person Operations, dated April 15, 2020. The Department of Health (Department) also issued guidance to health care providers in the form of Health Care Alerts (HANs) regarding isolation and quarantine, intended to allow for the continuation of life-sustaining health care services in the midst of the pandemic. Now, with the measured reopening of the Commonwealth, the Order of the Governor Regarding the Closure of All Businesses That Are Not Life Sustaining, dated March 19, 2020, as amended, and my Order Regarding the Closure of all Businesses That Are Not Life Sustaining, dated March 19, 2020, as amended, have been suspended. Despite the efforts taken to date, the pandemic continues to spread, and taking action to prevent that spread while continuing to allow for necessary resumption of economic and social activity requires the Commonwealth to take steps to minimize the danger to Pennsylvanians as a result of participating in that activity. In response to these concerns, in October, the Governor and I issued amendments to the Order of the Governor Directing Targeted Mitigation Measures, dated July 15, 2020, as amended, and my Order Directing Mitigation Measures, dated July 15, 2020, as amended. COVID-19 is a threat to the public’s health, for which the Secretary of Health may order general control measures, including, but not limited to, closure, isolation, and quarantine. This authority is granted to the Secretary of Health pursuant to Pennsylvania law. See section 5 of the Disease Prevention and Control Law, 35 P.S. § 521.5; sections 2102(a) and 2106 of the Administrative Code of 1929, 71 P.S. §§ 532(a), and 536; and the Department of Health’s regulations at 28 Pa. Code §§ 27.60-27.68 (relating to disease control measures; isolation; quarantine; movement of persons subject to isolation or quarantine; and release from isolation and quarantine). Particularly, the Department of Health has the authority to take any disease control measure appropriate to protect the public from the spread of infectious disease. See 35 P.S. § 521.5; 71 P.S. §§ 532(a), and 1403(a); 28 Pa. Code § 27.60. Under circumstances where social distancing, mask wearing and quarantine are the first line of defense against the disease’s spread, and where large and small gatherings are spreading disease,1 the experiences of the Commonwealth and its and the country’s health experts, and the recommendations of the Centers for Disease Control and Prevention (CDC) regarding travel and gatherings with persons not habitually together lead me to issue this Order as a protection against the spread of disease through our holiday season. Accordingly, on this day, November 17, 2020, in order to prevent and control the spread of disease, I hereby order: Section 1: Definitions a. “Isolation” means the separation of individuals with COVID-19 from individual who do not have COVID-19. b. “Quarantine” means the separation and restriction of the movement of individuals who were exposed to a contagious disease to see if they become sick or while they are awaiting the results of a COVID- 19 test. Section 2. Travel 1 Christie Aschwanden, “How ‘Superspreading’ Events Drive Most COVID-19 Spread,” Scientific American, https://www.scientificamerican.com/article/how-superspreading-events-drive-most-covid- 19-spread1/ (June 23, 2020); Carl Zimmer, “One Meeting in Boston Seeded Tens of Thousands of Infections, Study Finds,” New York Times, https://www.nytimes.com/2020/08/26/ health/covid-19-superspreaders-boston.html (Aug. 26, 2020); Jacqueline Howard, et al., “ Covid-19 superspreading event in Boston may have led to 20,000 cases, researcher says,” CNN, https://www.cnn.com/2020/08/25/health/covid-19-superspreading-boston-study/index.html (Aug. 25, 2020); Travis Anderson, “7 coronavirus-related deaths now connected to Maine wedding,” The Boston Globe, https://www.bostonglobe.com/2020/09/15/nation/coronavirus-death-toll-linked-maine- wedding-grows-five/; Lea Hamner, et al., “High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice—Skagit County, Washington, March 2020,” CDC, https://www.cdc.gov/mmwr/volumes/ 69/wr/mm6919e6.htm (May 15, 2020); Washington Post, https://www.washingtonpost.com/ politics/a-funeral-sparked-a-covid-19-outbreak--and-led-to-many-more-funerals/2020/04/03/546fa0cc- 74e6-11ea-87da-77a8136c1a6d_story.html (April 4, 2020); Laxminarayan, et al., Epidemiology and transmission dynamics of COVID-19 in two Indian states,” Science, https://science.sciencemag.org/content/early/2020/09/29/science.abd7672 (September 30, 2020). 2 Individuals traveling into and returning to the Commonwealth of Pennsylvania from any other State or Commonwealth or an international location, must produce evidence of a negative SARS-CoV2 (COVID-19) test from a specimen collected within 72 hours prior to entering the Commonwealth, or quarantine for 14 days upon entering, unless they qualify for one of the exemptions specified in Section 4. Section 3: Testing a. The test must be a diagnostic SARS-CoV2 test authorized by the Food and Drug Administration. b. Travelers who do not have their test results at the time of entry into the Commonwealth must remain at their travel destination without contact with others outside their travelling party until they receive their test results. Travelers receiving positive results must remain in isolation. Travelers receiving negative results may continue their intended activities. c. Travelers may temporarily leave quarantine to receive testing or other necessary medical services. d. Travelers must arrange for the test at their own expense. Section 4: Exemptions The following individuals are exempt from this testing and quarantine order but shall conduct travel with attention to social distancing and wearing of masks when in contact with other individuals. a. Individuals travelling to and from the Commonwealth for the purposes of work. b. Individuals travelling to and from the Commonwealth for medical reasons, including individuals providing comfort and support to the patient. c. Military personnel travelling to the Commonwealth by order or directive of a state or Federal military authority. d. Individuals in transit through the Commonwealth to another destination, provided that the time spent in the Commonwealth is only the amount of time necessary to complete the transit, make use of travel services, such as a highway rest stop, or make any necessary travel connection. 3 e. Additional exemptions may be issued in guidance documents issued by the Department. Section 5: Effective Date and Duration This Order shall take effect at 12:01 a.m. on November 20, 2020 and shall remain in effect until further notice. ________________________________ Rachel Levine, MD Secretary of Health 4 .